Abstract:Current state of the art to treat GMDs is primarily focused at the elimination of underlying trigger factors. Fluid and electrolyte management as well as laxatives and peripherally acting μ-opioid receptor antagonists are the recommended first-line therapies that can be complemented with prokinetics. Acupuncture as well as physical modalities, such as massage or warming of the abdomen, is promising with few side-effects and should be considered as well.
“…The critical difference between both drugs is in their utility: alvimopan is applied to treat opioid-naïve, while MNTX opioid-treated patients. Furthermore, alvimopan can be administrated only up to 8 days due to the possibility of myocardial events [135]. Fig.…”
Section: Opioid System In Pathophysiological Conditions Of the Gi Tractmentioning
Opioid receptors are widely distributed in the human body and are crucially involved in numerous physiological processes. These include pain signaling in the central and the peripheral nervous system, reproduction, growth, respiration, and immunological response. Opioid receptors additionally play a major role in the gastrointestinal (GI) tract in physiological and pathophysiological conditions. This review discusses the physiology and pharmacology of the opioid system in the GI tract. We additionally focus on GI disorders and malfunctions, where pathophysiology involves the endogenous opioid system, such as opioid-induced bowel dysfunction, opioid-induced constipation or abdominal pain. Based on recent reports in the field of pharmacology and medicinal chemistry, we will also discuss the opportunities of targeting the opioid system, suggesting future treatment options for functional disorders and inflammatory states of the GI tract.
“…The critical difference between both drugs is in their utility: alvimopan is applied to treat opioid-naïve, while MNTX opioid-treated patients. Furthermore, alvimopan can be administrated only up to 8 days due to the possibility of myocardial events [135]. Fig.…”
Section: Opioid System In Pathophysiological Conditions Of the Gi Tractmentioning
Opioid receptors are widely distributed in the human body and are crucially involved in numerous physiological processes. These include pain signaling in the central and the peripheral nervous system, reproduction, growth, respiration, and immunological response. Opioid receptors additionally play a major role in the gastrointestinal (GI) tract in physiological and pathophysiological conditions. This review discusses the physiology and pharmacology of the opioid system in the GI tract. We additionally focus on GI disorders and malfunctions, where pathophysiology involves the endogenous opioid system, such as opioid-induced bowel dysfunction, opioid-induced constipation or abdominal pain. Based on recent reports in the field of pharmacology and medicinal chemistry, we will also discuss the opportunities of targeting the opioid system, suggesting future treatment options for functional disorders and inflammatory states of the GI tract.
The number of scientific studies about acupuncture has increased significantly during recent years. Acupuncture can be used as an evidence-based adjunct therapy for a variety of indications in professional football. This review summarizes various acupuncture techniques and related techniques for utilization in the field of professional soccer. Besides knee, shoulder, spinal, elbow and postoperative pain, scientific meta-analyses also point towards the effectiveness of acupuncture in ankle sprains, allergic rhinoconjunctivitis and nausea. Dry needling is an emerging option for treatment of myofascial trigger points and could potentially result in improved prevention of muscular injuries and enhancement of muscular performance.
While no single currently available agent currently meets all of the desired goals in the critical care setting, there are an increasing number of available agents from which to choose including motilin receptor agonists, 5HT4 receptor agonists, D2 receptor antagonists, and Mu opioid receptor antagonists. We recommend a multifaceted approach to optimizing enteral nutrition in the critical care setting which should include the early, prophylactic use of promotility agents and should focus on the management of reversible causes of impaired gastrointestinal motility.
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